Cardiac rhythm management devices use relatively large capacitors to provide pulses of electrical energy. Specifically, cardiac rhythm management devices provide large pulses for therapies including defibrillation therapies. These capacitors are capable of delivering variable energy by varying their voltage. These capacitors are not able to deliver varying energy levels at a constant voltage. This inability presents several problems.
One problem is that in some instances, a load which receives a defibrillation pulse is not understood until after a device is connected to that load. Various application requirements specify that a certain amount of energy be delivered at a particular voltage and within a fixed time limit. If the first connected device is not sized appropriately, the inability to alter the energy storage capability of the device requires that the device be swapped with a second device having an appropriately sized capacitor. This complicates procedures used to connect a device to a load. This also requires the manufacture and inventory of multiple devices, with some devices being redundant. A new design is needed to overcome these problems.